Gebara W J, Weeks K J, Jones E L, Montana G S, Anscher M S
Department of Radiation Oncology, REX Hospital, Duke University Medical Center, 4420 Lake Boone Trail, Raleigh, Durham, NC 27607, USA.
Radiother Oncol. 2000 Jul;56(1):43-8. doi: 10.1016/s0167-8140(00)00176-6.
To describe external, internal and common iliac dose rates estimated with 3D-computed tomography (CT) based dose calculations in tandem and ovoid brachytherapy.
Thirty patients with carcinoma of the uterine cervix received low dose rate brachytherapy with a CT-compatible Fletcher-Suit-Deldos device. A total of 36 implants were performed with axial CT images used to identify internal iliac, external iliac, and common iliac vessels. Dose rates on the surfaces of these vessels were calculated for the purpose of estimating the dose to their associated lymph nodes.
In 22 out of 72 comparisons, point B overestimated the maximum dose with the external iliac nodes. In 21 out of 72 comparisons, point B overestimated the maximum dose with the internal iliac nodes. In all cases, Point B overestimated the minimum dose to the internal and external iliac nodal chains.
It was found that Point B dose is similar to the maximum common iliac nodal dose. Patient to patient variability, of Point B dose, warrants further study of dose distributions to the nodal chains. The minimum dose to the external iliac nodal chain at the bifurcation of the nodal chains may provide a useful measure of 'pelvic side wall dose' and deserves further study to see if it can be correlated with pelvic side wall control and complications.
描述在串联和卵形近距离放射治疗中，基于三维计算机断层扫描（CT）剂量计算所估算的髂外、髂内和髂总剂量率。
30例子宫颈癌患者接受了使用与CT兼容的弗莱彻 - 休伊特 - 德尔多斯装置进行的低剂量率近距离放射治疗。共进行了36次植入，利用轴向CT图像识别髂内、髂外和髂总血管。计算这些血管表面的剂量率，以估算其相关淋巴结的剂量。
在72次比较中的22次中，B点高估了髂外淋巴结的最大剂量。在72次比较中的21次中，B点高估了髂内淋巴结的最大剂量。在所有情况下，B点都高估了髂内和髂外淋巴结链的最小剂量。
发现B点剂量与髂总淋巴结最大剂量相似。B点剂量在患者之间的变异性，需要对淋巴结链的剂量分布进行进一步研究。在淋巴结链分叉处髂外淋巴结链的最小剂量，可能提供一种有用的“盆腔侧壁剂量”测量方法，值得进一步研究，以确定其是否与盆腔侧壁控制和并发症相关。
